Highlights

• Private vendors׳ involvement does not depend on who has the responsibility of the EHR system development.
• Private vendors׳ involvement can be found in all phases of the EHR system development.
• Indicates the necessity of more efforts to be made for the integration of Standards, for enhancing interoperability.
• Identifies which Standards supported by EHR system in operation worldwide.

Abstract:

The primary aim of this research is to capture the existing experience from countries where nationwide EHR systems have already been implemented or the development is in a mature phase. To capture the necessary information, an international survey has been conducted with expert participants from 13 countries. The results of this research show that private vendors׳ involvement in most of the system development lifecycle phases is inevitable. However, the phase where most private vendors are involved in during the development of an EHR system is System Design. Interestingly, their involvement does not depend on who has the responsibility of the EHR system development (either a national organization or a private vendor).

Finally, examining the supported standards by EHR systems and their interoperability with other information systems, in respect to both technical and semantic interoperability, it is found that more efforts should be made for the integration of the most widely supported standards, and the enhancement of interoperability among health information systems, which will lead to the successful integration of a NEHR system.